Excess Length Research Articles

Split staphylectomy to address soft palate thickness in brachycephalic dogs: 75 cases (2016-2018).

Describe the split staphylectomy procedure to address soft palate thickness and assess the complications and long-term outcome of this procedure as a part of multi-level surgery for brachycephalic obstructive airway syndrome. To consider whether same-day discharge following this surgery can be recommended. Medical records of dogs treated for brachycephalic obstructive airway syndrome using the split staphylectomy were reviewed. Owners were contacted to complete a questionnaire assessing initial postoperative concerns, the long-term outcome and the effect of surgery on their dog's quality of life. Seventy-five dogs underwent split staphylectomy during the study period. The overall complication rate was 8.3%, of which 2.7% were considered major. No life-threatening complications occurred, and no complications were related to the staphylectomy. The questionnaire was completed by 66.7% of owners (median follow-up 459 days), of which 88% felt that surgery had improved the quality of life for their dog. The majority (88%) of dogs were discharged from hospital on the day of surgery. Of the surveyed owners, 14% sought veterinary attention between their dog leaving the hospital and the scheduled postoperative reassessment 2 weeks after surgery. Four dogs were presented for veterinary intervention during this time period, but no intervention was related to the staphylectomy or for a life-threatening condition. The split staphylectomy offers a safe, straightforward method of addressing both excess thickness and length of soft palate in dogs with brachycephalic obstructive airway syndrome. Dogs can be discharged on the same day as brachycephalic obstructive airway syndrome surgery including split staphylectomy without an increased risk of complications.

Cut Cortical Screw Purchase in Diaphyseal Bone: A Biomedical Study.

IntroductionDuring fracture osteosynthesis, traumatologists may remove screws which are too long, cut the excess length from the screw tip, then reinsert the cut screw (CS) to minimize implant waste. The purpose of this study was to determine if this practice influences screw purchase.MethodsUsing an axial-torsion load device, the maximal insertion torque (MIT) required to insert 3.5 mm stainless steel cortical screws into normal and osteoporotic bone models was measured. MIT was determined in three different test conditions: (1) long screw (LS) insertion; (2) LS insertion, removal, and insertion of a normal-length screw (NS); and, (3) LS insertion, removal, cutting excess length from the screw tip, and reinserting the CS.ResultsIn the normal bone model, mean (± SD) MIT of LS insertion was 546 ± 6 Newton-centimeters (N-cm) compared to 496 ± 61 N-cm for NS reinsertion and 465 ± 69 N-cm for CS reinsertion. In the osteoporotic bone model, MIT of LS insertion was 110 ± 11 N-cm, whereas the values for NS and CS reinsertions were 98 ± 9 N-cm and 101 ± 12 N-cm, respectively. There was no significant difference in MIT between CS and NS reinsertions in the osteoporotic bone analog.ConclusionsCutting excess length from a 3.5 mm stainless steel cortical screw did not decrease its purchase regardless of bone density. During osteosynthesis, orthopaedists may remove screws which are too long, cut the screw tip, and reinsert the shortened screw as a cost-saving measure without compromising fracture fixation.

Edge rippling and petal shape of lilies

Ripples arise along flower petal edges of the species, Lilium casablanca, likely due to differential growth rates at the edges. Torn plastic sheets also exhibit edge ripples analogous to lily ripples. In both cases, the ripples are a consequence of excess edge length. Using both time-lapse videos of blooming lilies and still images of torn plastic sheets, we find that ripples in both systems are well-described by a scaling relationship where ripple amplitude is proportional to an expression dependent on ripple wavelength and arc length.

Coherent Multiantenna Receiver for BPSK-Modulated Ambient Backscatter Tags

Ambient backscatter communication (AmBC) is an emerging communication technology enabling green Internet of Things deployments. The widespread acceptance of this paradigm is limited by the low signal-to-interference-plus-noise ratio (SINR) of the signal impinging on the receiver antenna due to the strong direct path interference and unknown ambient signal. The adverse impact of these two factors can be mitigated by using noncoherent multiantenna receivers, which are known to require a higher SINR to reach the bit-error-rate (BER) performance of coherent receivers. However, considering the unknown ambient signal, unknown location of AmBC tags, and varying channel conditions, coherent receivers for AmBC systems are rarely studied in the literature. In this article, a coherent multiantenna receiver, which requires no prior information of the ambient signal for decoding the binary-phase-shift-keying (BPSK) modulated signal, is presented. The performance of the proposed receiver is compared with an ideal coherent receiver that has perfect phase information, and also with the performance of a noncoherent receiver, which assumes distributions for ambient signal and phase offset caused by the excess length of the backscatter path. Comparative simulation results show the designed receiver can achieve the same BER performance of the ideal coherent receiver with 1-dB more SINR, which corresponds to 5-dB or more gain with respect to noncoherent reception of on-off-keying modulated signals. Variation in the detection performance with the tag location shows that the coverage area is in the close vicinity of the transmitter and a larger region around the receiver, which is consistent with the theoretical results.

Global variation in the incidence of new-onset postoperative atrial fibrillation after cardiac and non-cardiac surgery: a systematic review

Aim: In the US, postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery and a frequent complication after non-cardiac surgery, causing excess patient length of stay and costs. After a comprehensive review looking for validated statistically significant data sets, too few data, particularly from outside of the US and Europe, could be found to perform a conclusive analysis, but there is enough data for a well-informed, educated opinion. Methods: A systematic review analyzing 28 international and US studies of POAF hospital length of stay were identified; from this excess and % excess along with total patient length of stay were calculated, where excess patient length of stay is defined as the difference in post-operative stay between POAF and non-POAF patients in days. Geographic variabilities were calculated using chi-square analyses for US regions and international comparisons for a variety of surgical procedures with POAF. Results: Geographic variability analyses when corrected for total hospital stay showed a 325% longer excess patient length of stay (days) in the US vs. Europe (3.4 days vs. 0.8 days) for coronary artery bypass grafting (CABG). It also showed a 27.3% longer excess patient length of stay (days) in the US vs. Europe (4.2 days vs. 3.3 days) for lung resections. These were both statistically significant at P < 0.001. Conclusion: There appear to be substantial variations in POAF-related care practices worldwide. In all practice settings, POAF causes increased patient length of stay. Europeans appear to do better than the US in POAF patients’ length of stay for CABG but not for lung resections. POAF is a worldwide problem where international cooperation in research and development of best practice guidelines would be particularly fruitful.

Принципы конструирования активных ортезов верхней конечности при вялых параличах

The purpose — to identify the cardinal principles of constructing active ortheses of a hand for self-service of invalids with different forms of flaccid paresis and paralyses. Material and methods. Based on the analysis of literature sources (276 neurological and 24 orthopedic) and determining the nature of neurological and biomechanical deficit of the upper limb function, we identified breaches of motor synergy during self-service test in 31 invalids with different forms and degrees of flaccid paresis and paralyses of the upper limb. The minimum group of operations and actions in vital activity was identified, which provides independent existence of an invalid. Accessibility of operations was researched on a stand-simulator of loads estimating the possibility (0; 1) and quality of their execution with scores 0 to 5. The parametric criteria of the action quality were: zonal reachability of the object (± Z), developed dinamometric effort of the hand (FN) and control cost (+ U) measured by the excess length of motion (+ ΔL). The execution time Ts was measured with a stopwatch. The efficiency of operations and actions was estimated with the standards of their structures and execution time. Electroactivity of the intact muscles was registered with a reference pattern: from the trapezium muscle to thenar and hypothenar of the hand. The structure? Amplitude and capacity of EMG were measured. Results. Active orthoses are divided into groups according to the preservation of the shoulder girdle, the forearm and the wrist muscles and the corresponding joints. Depending on the level of the lesion, either the hand grasping and holding and motor skills are disrupted, with a relatively preserved ability to manipulate the arm, or, conversely, the ability to manipulate the arm decreases with the preserved function of the hand grip. The reductions in the estimated parameters are very diverse for the disabled people. The electroactivity of the preserved muscles in paresis is destructive, but it is sufficient in capacity and can be used to control the active orthosis of the hand. Conclusions. The formulated seven principles make it possible to build an individual active orthosis of the upper limb for various types of flaccid paresis. The electroactivity of the preserved hand muscles is destructive, but sufficient in power and can be used to control the active orthosis. Using signals from other muscle groups is laborious and ineffective.

Excess Length of Stay and Readmission Following Hospital-Acquired Bacteraemia: A Population-Based Study

Excess Length of Stay and Readmission Following Hospital-Acquired Bacteraemia: A Population-Based Study

Thermo-physical properties of 1,3-Diaminopropane + alkyl acetate (C1-C4) liquid mixtures: Investigation of molecular interactions by insight of IR spectroscopy and DFT studies

The density (ρ) and speed of sound (u) data of 1,3-Diaminopropane (1,3-DAP) (1) + alkyl acetate (AAc) (C1-C4) (2) mixtures at the temperatures (298.15, 303.15, 308.15, 313.15, and 318.15) K and pressure 0.1 MPa were measured. ρ and u data have been used to calculate excess molar volume (VmE), excess molar isentropic compressibility (ksE), excess ultrasonic speed (uE), excess free volume (VfE), excess available volume (VaE) and excess intermolecular free length (LfE). The result of speed of sound have been analyzed in term of various correlations like Nomoto, Van Dael, Impedance dependence and Schaaff's collision factor theory at temperature 298.15 K. The calculated deviation and excess properties are well fitted with Redlich-Kister polynomial equation and further results were analyzed with the help of the structural, inter and intramolecular interaction aspects. IR spectra of the liquid mixture supported the intermolecular interaction between the 1,3-DAP and AAc molecules through shifting of the position of the stretching frequency of some specific functional groups. The results obtained from DFT studies clearly indicates the formation of strong intermolecular interaction between 1,3-DAP and AAc.

THERMO PHYSICAL PROPERTIES OF TERNARY MIXTURES OF 1-HEXANOL/1- OCTANOL CONTAINING N-N-DIMETHYLFORMAMIDE AND TOLUENE AT 303.15 K

In the present work, ultrasonic velocity (u), viscosity (η) and density (ρ) of ternary mixtures of 1-hexonal and 1-octanol with dimethylformamide in toluene at 303.15 K have been measured over the entire composition range. From the experimental data, acoustical parameters such as adiabatic compressibility (β), intermolecular free length (L ), free volume (V ), acoustic impedance (Z), excess adiabatic compressibility , excess free length , excess free f f E E (b ) (L )f volume and excess acoustic impedance have been computed. The variation of these properties with composition are E E (V ) (Z ) f discussed in terms of molecular interactions between unlike molecules of the mixtures.

Volumetric, acoustic and IR spectroscopic properties of binary mixtures (1,2-diaminopropane + methyl-, ethyl-, n-propyl- and n-butyl acetates: A combined experimental and first-principles investigation

Studies of density and speed of sound are commonly used tools to ascertain the properties of pure liquids and the nature of interactions between component molecules of a binary mixture. Herein, the density (ρ) and speed of sound (u) of methyl acetate (MAc), ethyl acetate (EAc), n-propyl acetate (n-PAc) and n-butyl acetate (n-BAc) and their binary mixture with 1,2-diaminopropane (1,2-DAP) were measured over the entire composition range at atmospheric pressure 0.1 MPa and in the temperature range of 298.15–318.15 K with a step of 5 K. Different excess thermo-physical properties including the excess molar volume (VmE), excess ultrasonic speed (uE), excess free volume (VfE), excess intermolecular free length (LfE), and excess molar isentropic compressibility were evaluated from the measured results of ρ and u. The evaluated properties were also analysed in terms of the extent and nature of interactions. The Redlich-Kister polynomial equation was used to correlate the various excess properties to the composition. Further, the u data is analysed by various correlations, Schaaff’s collision factor theory (CFT) and Jacobson’s free length theory (JFLT). The effect of chain length, branching and temperature on the intermolecular interactions and the magnitude of the measured properties have also been systematically analysed. Furthermore, excess molar properties and the intermolecular interactions have been interpreted in the light of Fourier transform infrared spectroscopy (FT-IR) and density functional theory (DFT) studies. Hydrogen-bonded interactions are predicted to play important role in stabilising the binary mixtures.

Reviewing the impacts of climate change on air transport operations

AbstractClimate change is increasing global-mean tropospheric temperatures, but the localised trends are uneven, including cooling the lower stratosphere and lifting the tropopause. The wind speeds are also being modified, both at the surface and aloft. A further effect, additional to wind and temperature alone, is of increasing fluctuations and severity of extreme weather. These are impacting air transport, and this will continue. The effects are known to include increased take-off distances where excess runway lengths exist and reduced payloads where they do not, increased en-route flight times, increased frequency and severity of encounters with clear air turbulence in some regions, changed patterns of wildlife — particularly bird — activity in some regions (potentially also for other anthropogenic reasons) are shifting locations of flight safety hazards, and increased burdens upon airport and associated infrastructure. There is increasing understanding and acknowledgment by companies and authorities of these effects and the importance of mitigating them, although this is not universal and there are as yet no universally understood best practices for air transport climate change mitigation.

Challenging weekend discharges associated with excess length of stay in surgical patients at Veterans Affairs hospitals

BackgroundChallenging discharges can lead to prolonged hospital stays. We hypothesized that surgical patients discharged from Veterans Affairs hospitals on weekdays have longer hospital stays and greater excess length of stay. MethodsWe identified inpatient general and vascular procedures at Veterans Affairs hospitals from 2007 to 2014. Expected length of stay was calculated using a stratified negative binomial model adjusted for patient/operative characteristics. Excess length of stay was defined as the difference between observed and expected length of stay. ResultsWe identified 135,875 patients (80.4% weekday discharges, 19.6% weekend discharges). The average length of stay was 7.5 days. Patients with weekday discharges spent on average 2.5 more days in the hospital compared with patients discharged on weekends (8.0 vs. 5.5 days, P < .001); 28.5% of patients with weekday discharges had an observed length of stay at least 1 day longer than expected, compared with 16.4% of patients with weekend discharges (P < .001). ConclusionSurgical patients are less frequently discharged from Veterans Affairs hospitals on the weekends than during the week, and this corresponds to an increased excess length of stay for patients ultimately discharged on weekdays. Exploring the opportunity to coordinate safe weekend discharges may improve efficiency of post-surgery hospital care and reduce healthcare costs.

Association between antibiotic resistance in intensive care unit (ICU)-acquired infections and excess resource utilization: Evidence from Spain, Italy, and Portugal.

Intensive care unit (ICU)-acquired infections with antibiotic-resistant bacteria have been associated with substantial health and economic costs. Moreover, southern Europe has historically reported high levels of antimicrobial resistance. We estimated the attributable economic burden of ICU-acquired infections due to resistant bacteria based upon hospital excess length of stay (LOS) in a selected sample of southern European countries. We studied a cohort of adult patients admitted to the ICU who developed an ICU-acquired infection related to an invasive procedure in a sample of Spanish, Italian, and Portuguese hospitals between 2008 and 2016, using data from The European Surveillance System (TESSy) released by the European Centers for Disease Control (ECDC). We analyzed the association between infections with selected antibiotic-resistant bacteria of public health importance and excess LOS using regression, matching, and time-to-event methods. We controlled for several confounding factors as well as time-dependent biases. We also computed the associated economic burden of excess resource utilization for each selected country. In total, 13,441 patients with at least 1 ICU-acquired infection were included in the analysis: 4,106 patients (30.5%) were infected with antimicrobial-resistant bacteria, whereas 9,335 patients (69.5%) were infected with susceptible bacteria. The unadjusted association between resistance status and excess LOS was 7 days (95% CI, 6.13-7.87; P < .001). Fully adjusted models yielded significantly lower estimates: 2.76 days (95% CI, 1.98-3.54; P < .001) in the regression model, 2.60 days (95% CI, 1.66-3.55; P < .001) in the genetic matching model, and a hazard ratio of 1.15 (95% CI, 1.11-1.19; P < .001) in the adjusted Cox regression model. These estimates, alongside the prevalence of resistance, translated into direct hospitalization attributable costs per ICU-acquired infection of 5,224€ (95% CI, 3,691-6,757) for Spain, 4,461€ (95% CI, 1,948-6,974) for Portugal, and 4,320€ (95% CI, 1,662-6,977) for Italy. ICU-acquired infections associated with antibiotic-resistant bacteria are substantially associated with a 15% increase in excess LOS and resource utilization in 3 southern European countries. However, failure to appropriately control for significant confounders inflates estimates by ∼2.5-fold.

Three-Flap Mastopexy with Reduction or Augmentation.

Many authors have studied breast ptosis and made contributions to the search for a procedure that allows its correction with long-lasting results and minimal scars. Collective evolution has allowed us to reach the point where we are today and will allow us to continue improving techniques in the future. The mastopexy procedure that we have used for the last 11 years, resulting from our surgical practice and countless observations at conferences, is a versatile procedure, applicable to different types of breasts and mastopexies with and without reduction or augmentation. Analysis and the clinical review of the patients and the records of the mastopexy cases that we operated on using the technique from January 2009 to March, 2020, are presented here. Using a periareolar approach for grade I ptosis and an inverted "T" approach for more severe ptosis, the excess skin is removed, and three flaps of breast tissue, superior, medial and lateral, are carved. A retromammary dissection is performed to anchor the end of the flaps, medial and lateral, to the pectoral aponeurosis, followed by invagination of these flaps to concentrate the breast tissue in the upper and central area of the breast. Closure of the wound is then performed, transforming its excess length into a short horizontal one, into the inframammary grove. Sixty-seven female patients, between 36 and 59 years old, underwent this procedure. Complications included hematoma (4%), overcorrection (4%), dehiscence (3.3%), residual ptosis (2.7%), pathological scarring (2.7%) and rotation folds (2%). Maximum follow-up was 8 years 2 months, mean follow-up 2 years 9 months, with satisfactory results for the patients and surgeon. The mastopexy procedure that we present here is a versatile technique, which can be applied to most cases requiring correction of ptosis. It provides the breast with proper shape, size and location with fewer scars. It is a logical, safe, efficient, reproducible procedure, which is easy to learn. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Study of Acoustical and Physico-chemical Properties for the Ternary Mixture of (Toluene+ Chlorobenzene + Cyclohexane) at 298.15 K Temperature

Ultrasonic velocity (U), density (ρ) for the ternary mixture of (Toluene + Chlorobenzene + Cyclohexane) in the various range of composition has been carried out at 298.15K. The observed data have been utilized to calculate various acoustical parameters like Isentropic compressibility (KS), Intermolecular free length (Lf) and acoustic impedance (Z). The various excess properties like excess ultrasonic velocity(UE ), excess acoustic impedance (ZE ), excess Isentropic compressibility (KS E ) and excess Inter molecular free length (Lf E ) have been calculated and using standard relations to the Redlich-Kister equation. The trend of acoustical and physicochemical parameters confirm the dynamics of molecules at temperature and the magnitude of intermolecular interactions among the constituents of the mixture always reflects the nature of substance. The variations in sign and values of these parameters are help us to know the interaction between component molecules and structural arrangement of the liquid mixture.

Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK

Healthcare-associated infection (HAI) is associated with increased morbidity and mortality resulting in excess costs. To investigate the impact of all types of HAI on the inpatient cost of HAI using different approaches. The incidence, types of HAI, and excess length of stay were estimated using data collected as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. Scottish NHS reference costs were used to estimate unit costs for bed-days. Variable (cash) costs associated with infection prevention and control (IPC) measures and treatment were calculated for each HAI type and overall. The inpatient cost of HAI is presented in terms of bed-days lost, bed-day costs, and cash costs. In Scotland 58,010 (95% confidence interval: 41,730-74,840) bed-days were estimated to be lost to HAI during 2018/19, costing £46.4 million (19m-129m). The total annual cost in the UK is estimated to be £774 million (328m-2,192m). Bloodstream infection and pneumonia were the most costly HAI types per case. Cash costs are a small proportion of the total cost of HAI, contributing 2.4% of total costs. Reliable estimates of the cost burden of HAI management are important for assessing the cost-effectiveness of IPC programmes. This unique study presents robust economic data, demonstrating that HAI remains a burden to the UK NHS and bed-days capture the majority of inpatient costs. These findings can be used to inform the economic evaluation and decision analytic modelling of competing IPC programmes at local and national level.

Trimmed central venous catheters in pediatric cardiac surgery: Does height or weight correlate with the amount trimmed?

Due to excess catheter length, pediatric patients undergoing cardiac surgery frequently have the tip of the central venous catheter trimmed while on bypass to obtain optimal catheter positioning. We sought to determine if there is a correlation between the patient's height or weight and the length of catheter removed. Our secondary aim compared the instances of central line-associated bloodstream infections and venous thromboembolisms between the trimmed and untrimmed catheters. This retrospective study included patients having undergone cardiac surgery over a 3-year period who had an 8cm central venous catheter placed in the right internal jugular vein. Hospital lists of central line-associated bloodstream infections and venous thromboembolisms that occurred were cross referenced with our study patients. There were 147 cases where the 8cm central venous catheter was trimmed, which represents 35% of the cases. Of the catheters that were cut, on average 2.17cm was removed. There is negligible correlation between the length of catheter removed and patient height (r=-.19, p = .021). There is negligible correlation between the length of catheter removed and patient weight (r=-.17, p = .039). There were no instances of central line-associated bloodstream infections or venous thromboembolisms attributed to the trimmed catheters. Of the 273 untrimmed catheters, there were no instances of an infection and one instance of a venous thromboembolism. Right internal jugular 8cm central venous catheters are trimmed during pediatric cardiac surgery, and there is minimal correlation between the length removed and the patient height or weight. Due to the difficulty in estimating the proper length of a central venous catheter in smaller pediatric patients, placing an 8cm long catheter in these patients and then trimming the distal tip while on bypass may be the most accurate way to properly position a catheter.

Lateral Domal Translocation and Medial Crural Transection: A Reliable Method for Nasal Tip Deprojection.

Nasal tip deprojection is a common goal in rhinoplasty. Several techniques have been described, many of which require destructive techniques that compromise the intrinsic integrity and morphology of the lateral crura. Through lateral translocation of the domes and shortening of the medial crura, nasal tip deprojection can be achieved without disrupting the integrity of the lateral crura. The domes are recreated lateral to the intrinsic domes with a standard transdomal suture, and excess length of the middle and medial crura is managed through transection and shortening of the medial crura. This technique preserves the morphology of the nasal base without altering the position of the medial crural footplates. Deprojection of 4 to 5 mm can be readily achieved with this technique.

Facing the Issues of Sheet Metal Equal‐Channel Angular Pressing: A Modified Approach Using Stacks to Produce Ultrafine‐Grained High Ductility AA5083 Sheets

A new approach for equal‐channel angular pressing (ECAP) of thin AA5083 sheets using two different orientations is investigated to address the issues of sheet metal ECAP. The method includes the deformation of a stack of 6 individual sheets supported by bulk material pieces placed on both sides of the stack. An excess length of the support materials and their pre‐deformation during an early stage of processing allows a buckling‐free deformation of the thin sheets for one of the investigated orientations. Multiple ECAP passes (up to N = 4) at room temperature following route C and microstructural analyses by electron back‐scatter diffraction are performed. Two passes of ECAP already result in considerable grain refinement with equiaxed grains, pronounced substructures and in an increased tensile strength at room temperature. At elevated temperatures (250 °C) a comparatively large elongation to failure (&gt;130%) is found for the fine‐grained sheets. Diffusion‐controlled deformation mechanisms likely contribute to the deformation behavior of the investigated material. Scanning electron microscopy of the tensile specimens after testing reveals the formation of elongated and large cavities. These results highlight the suitability of the modified experimental method to produce (ultra)fine‐grained thin aluminum sheets with distinctly increased strength and ductility.

The healthcare costs of antimicrobial resistance in Lebanon: a multi-centre prospective cohort study from the payer perspective

BackgroundOur aim was to examine whether the length of stay, hospital charges and in-hospital mortality attributable to healthcare- and community-associated infections due to antimicrobial-resistant bacteria were higher compared with those due to susceptible bacteria in the Lebanese healthcare settings using different methodology of analysis from the payer perspective .MethodsWe performed a multi-centre prospective cohort study in ten hospitals across Lebanon. The sample size consisted of 1289 patients with documented healthcare-associated infection (HAI) or community-associated infection (CAI). We conducted three separate analysis to adjust for confounders and time-dependent bias: (1) Post-HAIs in which we included the excess LOS and hospital charges incurred after infection and (2) Matched cohort, in which we matched the patients based on propensity score estimates (3) The conventional method, in which we considered the entire hospital stay and allocated charges attributable to CAI. The linear regression models accounted for multiple confounders.ResultsHAIs and CAIs with resistant versus susceptible bacteria were associated with a significant excess length of hospital stay (2.69 days [95% CI,1.5–3.9]; p < 0.001) and (2.2 days [95% CI,1.2–3.3]; p < 0.001) and resulted in additional hospital charges ($1807 [95% CI, 1046–2569]; p < 0.001) and ($889 [95% CI, 378–1400]; p = 0.001) respectively. Compared with the post-HAIs analysis, the matched cohort method showed a reduction by 26 and 13% in hospital charges and LOS estimates respectively. Infections with resistant bacteria did not decrease the time to in-hospital mortality, for both healthcare- or community-associated infections. Resistant cases in the post-HAIs analysis showed a significantly higher risk of in-hospital mortality (odds ratio, 0.517 [95% CI, 0.327–0.820]; p = 0.05).ConclusionThis is the first nationwide study that quantifies the healthcare costs of antimicrobial resistance in Lebanon. For cases with HAIs, matched cohort analysis showed more conservative estimates compared with post-HAIs method. The differences in estimates highlight the need for a unified methodology to estimate the burden of antimicrobial resistance in order to accurately advise health policy makers and prioritize resources expenditure.